Accuracy of Zika virus disease case definition during simultaneous Dengue and Chikungunya epidemics
Accuracy of Zika virus disease case definition during simultaneous Dengue and Chikungunya epidemics
Data
2017
Autores
Braga, José Ueleres
Bressan, Clarisse
Dalvi, Ana Paula Razal
Calvet, Guilherme Amaral
Daumas, Regina Paiva
Rodrigues, Nadia
Wakimoto, Mayumi
Nogueira, Rita Maria Ribeiro
Nielsen-Saines, Karin
Brito, Carlos
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS One
Resumo
Background
Zika is a new disease in the American continent and its surveillance is of utmost importance,
especially because of its ability to cause neurological manifestations as Guillain-Barre ́ syn-
drome and serious congenital malformations through vertical transmission. The detection of
suspected cases by the surveillance system depends on the case definition adopted. As the
laboratory diagnosis of Zika infection still relies on the use of expensive and complex molec-
ular techniques with low sensitivity due to a narrow window of detection, most suspected
cases are not confirmed by laboratory tests, mainly reserved for pregnant women and new-
borns. In this context, an accurate definition of a suspected Zika case is crucial in order for
the surveillance system to gauge the magnitude of an epidemic.
Methodology
We evaluated the accuracy of various Zika case definitions in a scenario where Dengue and
Chikungunya viruses co-circulate. Signs and symptoms that best discriminated PCR con-
firmed Zika from other laboratory confirmed febrile or exanthematic diseases were identified
to propose and test predictive models for Zika infection based on these clinical features.
Results and discussion
Our derived score prediction model had the best performance because it demonstrated the
highest sensitivity and specificity, 866% and 783%, respectively. This Zika case definition
also had the highest values for auROC (0903) and R2 (0417), and the lowest Brier score
0096.
Conclusions
In areas where multiple arboviruses circulate, the presence of rash with pruritus or conjuncti-
val hyperemia, without any other general clinical manifestations such as fever, petechia or
anorexia is the best Zika case definition.
Description
Palavras-chave
Adolescent, Adult, Aged, Aged, 80 and over, Brazil / epidemiology, Chikungunya Fever / diagnosis, Chikungunya Fever / epidemiology*, Child, Child, Preschool, Cross-Sectional Studies, Dengue / diagnosis, Dengue / epidemiology*, Diagnosis, Differential, Epidemics*, Epidemiological Monitoring, Female, Humans, Infant, Infant, Newborn, Infectious Disease Transmission, Vertical, Male, Middle Aged, Models, Statistical, Predictive Value of Tests, Pregnancy, Young Adult, Zika Virus Infection / diagnosis*, Zika Virus Infection / epidemiology*, Zika Virus Infection / transmission
Citação
Braga JU, Bressan C, Dalvi APR, Calvet GA, Daumas RP, Rodrigues N, et al. (2017). Accuracy of Zika virus disease case definition during simultaneous Dengue and Chikungunya epidemics. PLoS ONE 12(6): e0179725. Doi: 10.1371/journal.pone.0179725